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BORGHI A, SCOTTO DI UCCIO A, GRONCHI A. Primary malignancy of the inferior vena cava, a review of surgical treatments and outcomes. THE JOURNAL OF CARDIOVASCULAR SURGERY 2022; 63:649-663. [DOI: 10.23736/s0021-9509.22.12418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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2
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Voit A, Commander SJ, Williams Z. Partial Inferior Vena Cava Reconstruction with Cryopreserved Aortic Homograft Following Resection for Malignancy. Vasc Endovascular Surg 2022; 57:79-82. [DOI: 10.1177/15385744221124297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Malignant invasion of the inferior vena cava (IVC) often necessitates complete tumor thrombectomy and IVC reconstruction. Bovine pericardial xenografts and prosthetic grafts are frequently used for partial or entire IVC reconstruction with adequate subsequent patency and freedom from thrombosis. Cryopreserved aortic homografts represent an alternative conduit for vena cava replacement with resistance to infection in contaminated fields or following extensive retroperitoneal dissection. Specific reports of aortic homograft use for IVC reconstruction are scarce. Described are 2 cases of cryopreserved aortoiliac artery allograft use for long segment cava patch repair while avoiding extensive caval reconstruction, mobilization and the need for renal vein and hepatic vein re-implantation.
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Affiliation(s)
- Antanina Voit
- Division of Vascular and Endovascular Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sarah Jane Commander
- Division of Vascular and Endovascular Surgery, Duke University Medical Center, Durham, NC, USA
| | - Zachary Williams
- Division of Vascular and Endovascular Surgery, Duke University Medical Center, Durham, NC, USA
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Alslaim H, Chung J, Kruse E, Shukla M, Agarwal G. Iatrogenic Inferior Vena Cava Resection Requiring Reconstruction. Vasc Endovascular Surg 2021; 55:864-868. [PMID: 33906552 DOI: 10.1177/15385744211012904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This is a report of an iatrogenic inferior vena cava (IVC) segmental resection and reconstruction utilizing bovine pericardium. A 48-year-old female patient presented for a planned right nephrectomy by the urology service secondary to xanthogranulomatous pyelonephritis. This was complicated by inadvertent resection of an 8 cm segment of the infrarenal IVC. Postoperatively, the patient did not tolerate IVC ligation due to severe lower extremity edema. She then underwent reconstruction with a bovine pericardium conduit as an interposition graft. The post-operative course was complicated by pulmonary embolism requiring percutaneous intervention. This report addresses the utility of bovine pericardium for IVC reconstruction in an infected field.
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Affiliation(s)
- Hossam Alslaim
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Jane Chung
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Edward Kruse
- Division of Surgical Oncology, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Mrinal Shukla
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
| | - Gautam Agarwal
- Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Georgia at Augusta University, GA, USA
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Zhang XX, Zhu JQ, Zhang H, Kou JT, Ma J, He Q. Resection of a retrohepatic leiomyosarcoma of the inferior vena cava combined with caudate lobectomy and reconstruction with an allogenic vein. Hepatobiliary Pancreat Dis Int 2021; 20:80-82. [PMID: 32847742 DOI: 10.1016/j.hbpd.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/05/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Xin-Xue Zhang
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Ji-Qiao Zhu
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Zhang
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jian-Tao Kou
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jun Ma
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Qiang He
- Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
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Buchholz BM, Pinter Carvalheiro da Silva Boteon A, Taniere P, Isaac JR, Gourevitch D, Muiesan P. Autotransplantation of the Liver for Ex Vivo Resection of Intrahepatic Caval Leiomyosarcoma: A Case Report. EXP CLIN TRANSPLANT 2020; 18:396-401. [DOI: 10.6002/ect.2018.0183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Nooromid MJ, Caicedo JC, Pham DT, Kundu SD, Eskandari MK. Successful Resection of a Retrohepatic Inferior Vena Cava Primary Leiomyosarcoma with Atrial Thrombus Extension in a 30-Week Pregnant Woman. Ann Vasc Surg 2020; 68:567.e11-567.e15. [PMID: 32428643 DOI: 10.1016/j.avsg.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 12/12/2022]
Abstract
Leiomyosarcomas are an uncommon malignant subset of tumors accounting for approximately 20% of soft tissue sarcomas. Primary vascular leiomyosarcomas (PVLs) are a rare subset of leiomyosarcomas that may originate in the arterial or venous circulation but most commonly affect the inferior vena cava (IVC). PVLs more commonly affect women to men in a 2:1 ratio and most frequently occur in the fourth to sixth decades of life. Few reports have described this infrequent pathologic state in the setting of advanced pregnancy. Presented is a case of a 44-year-old 30-week pregnant woman who presented with a PVL of the retrohepatic IVC, which was complicated by occlusion of the IVC and tumor thrombus extension into the hepatic veins and right atrium. Herein, we describe our multidisciplinary management of this rare problem with successful surgical resection of her tumor and IVC reconstruction.
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Affiliation(s)
- Michael J Nooromid
- Division of Vascular Surgery, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Juan C Caicedo
- Division of Transplantation Surgery, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Duc T Pham
- Division of Cardiac Surgery, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Shilajit D Kundu
- Department of Urology, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Mark K Eskandari
- Division of Vascular Surgery, Northwestern Feinberg School of Medicine, Chicago, IL.
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Theodoraki K, Kostopanagiotou K, Theodosopoulos T, Vassiliu P, Kizgala P, Parasyris S, Bouzalas D, Arkadopoulos N, Smyrniotis V. Resection of abdominal inferior vena cava without graft interposition: Considerations in preserving renal function. J Surg Oncol 2018; 118:704-708. [PMID: 30079542 DOI: 10.1002/jso.25191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/11/2018] [Indexed: 11/10/2022]
Abstract
The management of tumors involving or infiltrating the inferior vena cava (IVC) constitutes a great surgical challenge, since radical resection affords patients the only possibility for long-term survival. These tumors can be resected without graft interposition, provided that there is adequate collateral circulation and that the renal function can be secured. Meanwhile, ligation of the left renal vein may be possible due to the existence of collateral circulation through the adrenal and gonadal veins. We briefly present our experience on renal outflow preservation through implantation of the right renal vein into the IVC stump or through diversion of the left renal vein into the inferior mesenteric vein.
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Affiliation(s)
- Kassiani Theodoraki
- Department of Anesthesiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kostopanagiotou
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodosios Theodosopoulos
- Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Pantelis Vassiliu
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Polyxeni Kizgala
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Parasyris
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dionysios Bouzalas
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Arkadopoulos
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilios Smyrniotis
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Leiomyosarcoma of the Inferior Vena Cava: A Case Series and Review of the Literature. Ann Vasc Surg 2016; 33:245-51. [DOI: 10.1016/j.avsg.2015.10.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/04/2015] [Accepted: 10/15/2015] [Indexed: 12/20/2022]
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Etkin Y, Foley PJ, Wang GJ, Guzzo TJ, Roses RE, Fraker DL, Drebin JA, Jackson BM. Successful venous repair and reconstruction for oncologic resections. J Vasc Surg Venous Lymphat Disord 2016; 4:57-63. [DOI: 10.1016/j.jvsv.2015.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/12/2015] [Indexed: 12/22/2022]
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Delayed reconstruction with cryopreserved vein of an iatrogenically ligated inferior vena cava. J Vasc Surg Venous Lymphat Disord 2014; 2:74-6. [DOI: 10.1016/j.jvsv.2013.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 02/03/2023]
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Padilla-Fernandez B, Lorenzo-Gomez MF, Herrero-Polo M, Silva-Abuin JM, Martin-Izquierdo M, Antunez-Plaza P. Leiomyosarcoma of the inferior vena cava in a patient with double inferior vena cava. Ann Vasc Surg 2012; 26:859.e1-5. [PMID: 22717359 DOI: 10.1016/j.avsg.2011.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 07/03/2011] [Accepted: 11/04/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor arising from its smooth muscle cells. METHODS AND RESULTS We report the case of a 38-year-old woman presenting with back pain and weight loss who was diagnosed with a 22-cm leiomyosarcoma of the right IVC and thrombosis of the left IVC. The patient is alive and free of recurrence a year after radical tumor resection with removal of the affected IVC, reconstruction with polytetrafluoroethylene prosthetic graft, and anastomosis of both right and left IVC. CONCLUSIONS Leiomyosarcoma is a rare and aggressive tumor with a deceitful course. Radical surgical en bloc resection is the mainstay of treatment for IVC leiomyosarcomas. For an adequate restoration of venous return, complex vascular repair may be necessary.
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Early diagnosis and resection of an asymptomatic leiomyosarcoma of the inferior vena cava prior to caval obstruction. J Vasc Surg 2012; 55:525-8. [DOI: 10.1016/j.jvs.2011.06.112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/20/2011] [Accepted: 06/25/2011] [Indexed: 11/24/2022]
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Ghosh J, Bhowmick A, Baguneid M. Oncovascular surgery. Eur J Surg Oncol 2011; 37:1017-24. [PMID: 21917411 DOI: 10.1016/j.ejso.2011.08.131] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/11/2011] [Accepted: 08/22/2011] [Indexed: 01/31/2023] Open
Affiliation(s)
- J Ghosh
- Department of Vascular Surgery, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Greater Manchester, UK.
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Al-Saif OH, Sengupta B, Amr S, Meshikhes AW. Leiomyosarcoma of the infra-renal inferior vena cava. Am J Surg 2011; 201:e18-20. [DOI: 10.1016/j.amjsurg.2010.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 03/09/2010] [Accepted: 03/09/2010] [Indexed: 10/18/2022]
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Kyriazi MA, Stafyla VK, Chatzinikolaou I, Koureas A, Chatziioannou A, Kondi-Paphiti A, Arkadopoulos N, Smyrniotis V. Surgical Challenges in the Treatment of Leiomyosarcoma of the Inferior Vena Cava: Analysis of Two Cases and Brief Review of the Literature. Ann Vasc Surg 2010; 24:826.e13-7. [DOI: 10.1016/j.avsg.2010.02.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 11/03/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Saeb-Parsy K, Jah A, Butler AJ, Large S, Pettigrew GJ, Praseedom RK, Watson CJ, Jamieson NV. Use of a donor aortic interposition allograft to treat stenosis of the suprahepatic inferior vena cava after liver transplantation. Liver Transpl 2009; 15:662-5. [PMID: 19479812 DOI: 10.1002/lt.21655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Kourosh Saeb-Parsy
- Department of Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
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Cho SW, Marsh JW, Geller DA, Holtzman M, Zeh H, Bartlett DL, Gamblin TC. Surgical management of leiomyosarcoma of the inferior vena cava. J Gastrointest Surg 2008; 12:2141-8. [PMID: 18841423 DOI: 10.1007/s11605-008-0700-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2008] [Accepted: 09/08/2008] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor for which en bloc resection offers the only chance of cure. Due to its rarity, however, optimal strategies for the management of the primary tumor and subsequent recurrences are not well defined. METHODS We performed a retrospective review of patients who underwent surgical resection of IVC leiomyosarcoma. We evaluated clinical presentations, operative techniques, patterns of recurrence and survival. RESULTS From 1990 to 2008, nine patients (four females) were identified. Median age was 55 years (40-76). Presentations included abdominal pain (n = 5), back pain (n = 2), leg swelling (n = 4) and abdominal mass (n = 2). Pre-operative imaging studies showed tumor location to be from the right atrium to renal veins (n = 1), retrohepatic (n = 5), and from hepatic veins to the iliac bifurcations (n = 3). En bloc resection included right nephrectomy (n = 5), right adrenalectomy (n = 4), pancreaticoduodenectomy (n = 1), right hepatic trisectionectomy (n = 1) and right hemicolectomy (n = 1). The IVC was ligated in six patients, and a prosthetic graft was used for IVC reconstruction in three patients. Resection margins were negative in seven cases. Median length of stay was 12 days (range, 6-22 days). Major morbidity included renal failure (n = 1) and there was one post-operative mortality. Five patients had leg edema post-operatively, four of whom had IVC ligation. Median survival was 47 months (range, 1-181 months). Four patients had recurrence and the median time to recurrence was 14 months (range, 3-25 months). Two patients underwent successful resection of recurrence. CONCLUSIONS Curative resection of IVC leiomyosarcoma can lead to long-term survival. However, recurrence is common, and effective adjuvant treatments are needed. In selected cases, aggressive surgical treatment of recurrence should be considered.
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Affiliation(s)
- S W Cho
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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Bertini R, Suardi N, Marone EM, Roscigno M, Petralia G, Strada E, Cestari A, Arrigoni G, Guazzoni G, Montorsi F, Chiesa R, Rigatti P. Pregnant Woman Presenting with a Gross Retroperitoneal Mass: Surgical Treatment with Caval Replacement. Eur Urol 2008; 54:677-80. [DOI: 10.1016/j.eururo.2008.06.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 06/13/2008] [Indexed: 11/16/2022]
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